958 research outputs found
Botrytis in wine grapes in Western Australia
Botrytis, causal agent Botrytis cinerea, is a fungal disease of grapevines that is commonly referred to as Botrytis bunch rot or grey mould. Botrytis is most prevalent where warm, wet conditions are frequent, but symptoms can occur in cool, wet weather and high humidity. All grape varieties are susceptible. Varieties most at risk are those with berries that are thin-skinned and/or have tight bunches.
Some white wine grape varieties infected with Botrytis may decay, in certain conditions to produce noble rot . Wine produced from these infected bunches produce unique aromatic characters with high residual sugar and are usually sold as dessert wines.https://researchlibrary.agric.wa.gov.au/bulletins/1092/thumbnail.jp
Breathing Space
‘Breathing space’ is about marking time through breath. When breath stops, time stops for each individual chronology. Re-iteration, repeating with variation again and again, in and out, is the rhythm of craft, of skill in drawing and making. Reiteration mirrors the arduous patterns of ancient textiles, ceramics, or inscriptions, patterns derived from images of feathers, scales, or leaves
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Medical Students' Death Anxiety: Severity and Association With Psychological Health and Attitudes Toward Palliative Care.
CONTEXT: Death anxiety (DA) is related to awareness of the reality of dying and death and can be negatively related to a person's psychological health. Physicians' DA also may influence their care for patients approaching death. Doctors face death in a professional context for the first time at medical school, but knowledge about DA among medical students is limited. OBJECTIVES: This study examined medical students' DA in relation to: 1) its severity, gender differences, and trajectory during medical education and 2) its associations with students' attitudes toward palliative care and their psychological health. METHODS: Four cohorts of core science and four cohorts of clinical students at the University of Cambridge Medical School took part in a questionnaire survey with longitudinal follow-up. Students who provided data on the revised Collett-Lester Fear of Death Scale were included in the analysis (n = 790). RESULTS: Medical students' DA was moderate, with no gender differences and remained very stable over time. High DA was associated with higher depression and anxiety levels and greater concerns about the personal impact of providing palliative care. CONCLUSION: The associations between high DA and lower psychological health and negative attitudes toward palliative care are concerning. It is important to address DA during medical education to enhance student's psychological health and the quality of their future palliative care provision.The study was funded by the University of Cambridge School of Clinical Medicine and Research Capacity Funding from the Cambridgeshire and Peterborough Clinical Commissioning Group. Dr. Barclay is supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) East of England at Cambridgeshire and Peterborough NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The authors declare no conflicts of interest.This is the accepted manuscript of a paper published in the Journal of Pain and Symptom Management (Thiemann P, Quince T, Benson J, Wood D, Barclay S, Journal of Pain and Symptom Management (2015) 50(3); 335-342, doi:10.1016/j.jpainsymman.2015.03.014). The final version is available at http://dx.doi.org/10.1016/j.jpainsymman.2015.03.01
Learning to care: medical students' reported value and evaluation of palliative care teaching involving meeting patients and reflective writing.
BACKGROUND: Over recent years there has been an increase in teaching of both palliative care and reflective practice in UK medical schools. The palliative care teaching at the University of Cambridge School of Clinical Medicine is multi-faceted and involves students writing reflective essays after individually meeting patients approaching the end of life during their final year general practice and hospital medicine placements. This paper draws on two studies examining this teaching element to analyse what the students found valuable about it and to comment on the practice of meeting patients and subsequent reflective writing. METHODS: Two studies have explored students' perceptions of these course components. The first was a thematic analysis of 234 reflective essays from 123 students written in 2007-2008, including examining what students wrote about the exercise itself. The second project involved a semi-structured questionnaire that students completed anonymously; this paper reports on the free text elements of that study [sample size =107]. Since similar themes were found in both studies, the coding structures from each project were compared and combined, enabling triangulation of the findings around what the students found valuable from the palliative care teaching involving meeting patients and reflective writing. RESULTS: Overall, students reported that these components of the palliative care teaching are valuable. Four main themes were identified as aspects that students valued: (1) dedicated time with patients, (2) learning about wider elements of treatment and holistic care, (3) practicing communication skills, and (4) learning about themselves through reflective writing. Some students expressed a dislike for having to formally write a reflective essay. CONCLUSION: It is possible to arrange for all of the medical students to individually meet at least two patients receiving palliative or end of life care. Students found these encounters valuable and many wrote about the benefit of formally writing about these experiences. Students reported finding this model useful in widening their skill-set and understanding of palliative care
Attitudes of medical students to medical leadership and management: a systematic review to inform curriculum development.
BACKGROUND: There is a growing acknowledgement that doctors need to develop leadership and management competences to become more actively involved in the planning, delivery and transformation of patient services. We undertook a systematic review of what is known concerning the knowledge, skills and attitudes of medical students regarding leadership and management. Here we report the results pertaining to the attitudes of students to provide evidence to inform curriculum development in this developing field of medical education. METHODS: We searched major electronic databases and citation indexes within the disciplines of medicine, education, social science and management. We undertook hand searching of major journals, and reference and citation tracking. We accessed websites of UK medical institutions and contacted individuals working within the field. RESULTS: 26 studies were included. Most were conducted in the USA, using mainly quantitative methods. We used inductive analysis of the topics addressed by each study to identity five main content areas: Quality Improvement; Managed Care, Use of Resources and Costs; General Leadership and Management; Role of the Doctor, and Patient Safety. Students have positive attitudes to clinical practice guidelines, quality improvement techniques and multidisciplinary teamwork, but mixed attitudes to managed care, cost containment and medical error. Education interventions had variable effects on students' attitudes. Medical students perceive a need for leadership and management education but identified lack of curriculum time and disinterest in some activities as potential barriers to implementation. CONCLUSIONS: The findings from our review may reflect the relatively little emphasis given to leadership and management in medical curricula. However, students recognise a need to develop leadership and management competences. Although further work needs to be undertaken, using rigorous methods, to identify the most effective and cost-effective curriculum innovations, this review offers the only currently available summary of work examining the attitudes of students to this important area of development for future doctors.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are
Stability of empathy among undergraduate medical students: a longitudinal study at one UK medical school.
BACKGROUND: Empathy is important to patient care. The prevailing view is that empathy declines during university medical education. The significance of that decline has been debated.This paper reports the findings in respect of two questions relating to university medical education: 1. Do men and women medical students differ in empathy? 2. Does empathy change amongst men and women over time? METHODS: The medical course at the University of Cambridge comprises two components: Core Science (Years 1-3) and Clinical (Years 4-6). Data were obtained from repeated questionnaire surveys of medical students from each component over a period of four years: 2007-2010. Participation in the study was voluntary.Empathy was measured using two subscales of the Interpersonal Reactivity Index: IRI-EC (affective empathy) and IRI-PT (cognitive empathy). We analysed data separately for men and women from the Core Science and Clinical components. We undertook missing value analyses using logistic regression separately, for each measure of empathy, to examine non-response bias. We used Student's t-tests to examine gender differences and linear mixed effects regression analyses to examine changes over time. To assess the influence of outliers, we repeated the linear mixed effects regression analyses having excluded them. RESULTS: Women displayed statistically significant higher mean scores than men for affective empathy in all 6 years of medical training and for cognitive empathy in 4 out of 6 years - Years 1 and 2 (Core Science component) and Years 4 and 5 (Clinical component).Amongst men, affective empathy declined slightly during both Core Science and Clinical components. Although statistically significant, both of these changes were extremely small. Cognitive empathy was unchanged during either component. Amongst women, neither affective empathy nor cognitive empathy changed during either component of the course.Analysis following removal of outliers showed a statistically significant slight increase in men's cognitive empathy during the Core Science component and slight decline in women's affective empathy during the Clinical component. Again, although statistically significant, these changes were extremely small and do not influence the study's overall conclusions. CONCLUSIONS: Amongst medical students at the University of Cambridge, women are more empathetic than men (a generally observed phenomenon). Men's affective empathy declined slightly across the course overall, whilst women's affective empathy showed no change. Neither men nor women showed any change in cognitive empathy during the course. Although statistically significant, the size of such changes as occurred makes their practical significance questionable. Neither men nor women appear to become meaningfully less empathetic during their medical education at the University of Cambridge.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are
Medical students' experience of personal loss: incidence and implications.
BACKGROUND: Medical students are generally young people, often away from home for the first time and undertaking a course in which they are learning to care for people at all stages of life, including those approaching death. Existing research indicates that their experiences of personal bereavement may have significant implications for their pastoral welfare and medical learning. No previous studies have tracked medical student experience of bereavement longitudinally and no recent data are available from the UK. AIMS: The study aims to identify medical students' experience of personal bereavement: the prevalence prior to and during the course and their relationship with those who died. METHOD: Paper and online questionnaire including questions about recent personal loss. SETTING / PARTICIPANTS: Four cohorts of core science and clinical medical students at the University of Cambridge, 1021 participants in total. RESULTS: Mean response rate was 65.2% for core science students and 72.8% for clinical students. On entry to the core science course, 23.1% of all students had experienced a loss at some point. Between 13.0% and 22.5% experienced bereavement during years 1 - 5 of the course: some (1.3% - 6.3%) experienced multiple or repeated losses. Close deaths reported were most commonly those of grandparents followed by friends. CONCLUSIONS: Medical students commonly experience close personal bereavement, both before and during their course. Educators need to be aware of the range of personal and educational implications of bereavement for medical students, and ensure that appropriate help is available. Further research could explore incidence of loss at other medical schools and investigate the impact and depth of experience of loss.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are
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